AIDS worker calls for drug pipes to com­bat HIV rates

Al­ter­na­tive to nee­dles may re­duce risk

Ottawa Citizen - - CANADA - Ryan McKenna

REGINA• An AIDS sup­port worker in Saskatchewan says pipes should be more avail­able to drug users if the prov­ince wants to re­duce HIV rates that are among the high­est in North Amer­ica.

Ja­son Mer­credi of AIDS Saska­toon said there aren’t any pipes avail­able as a means of harm re­duc­tion in Saskatchewan.

The prov­ince says that is be­cause as­sess­ments have not in­di­cated a need.

The pipes can be used to smoke crack co­caine and metham­phetamine. Ac­quir­ing HIV from a pipe is less likely be­cause the dis­ease has been ex­posed to air. HIV can live longer in a nee­dle be­cause it’s a sealed con­tainer. The hope is, if pipes are more avail­able drug users would use them to get high in­stead of nee­dles.

“The chance of get­ting HIV or pass­ing on HIV through a meth pipe is very slim,” Mer­credi said. “The rate drops quite a bit.”

Saskatchewan has con­sis­tently been plagued by high rates of HIV in­fec­tion. Rates in 2016 — the most re­cent avail­able data — were more than 10 times the na­tional av­er­age in some ar­eas. Nearly 80 per cent of peo­ple with HIV in the prov­ince are Indige­nous.

The prov­ince cur­rently pro­vides $562,000 an­nu­ally for drug harm-re­duc­tion pro­grams to dif­fer­ent or­ga­ni­za­tions. Some pro­grams pro­vide nee­dles, syringes, and ed­u­ca­tion sup­port to sub­stance users, while oth­ers have nalox­one kits and con­doms.

Saskatchewan doesn’t have a safe in­jec­tion site, although Dr. Denise Werker, the prov­ince’s deputy chief med­i­cal health of­fi­cer, said there have been dis­cus­sions about cre­at­ing them in Saska­toon and Prince Al­bert.

Pipes are be­ing pro­vided in other parts of the coun­try.

Kero Sakeub, with the AIDS Com­mit­tee of Toronto, said safe in­jec­tion sites in that city of­ten have pipes avail­able.

“Pipes are a safer op­tion over snort­ing and injections,” Sakeub said. “Sim­ply be­cause there’s no blood in­volved and it’s just saliva and you can’t just get HIV from saliva.”

Sakeub did note that hepati­tis is eas­ily trans­mis­si­ble through shar­ing a pipe.

Maxime Blanchette, a so­cial worker with L’Actuel sex­ual health clinic in Mon­treal, said smok­ing drugs in­stead of in­ject­ing helps peo­ple kick their ad­dic­tion.

“They’re alive. They’re feel­ing well with us­ing the pipes in­stead of the nee­dles,” Blanchette said. “They’re more ready to de­crease the con­sump­tion.”

But Shel­ley Mar­shall, a pub­lic health nurse with the Win­nipeg Re­gional Health Author­ity, noted that while it is very un­likely to spread HIV, there is no ev­i­dence hand­ing out pipes helps with in­fec­tion rates.

“There’s no hard ev­i­dence that dis­tribut­ing pipes re­duces HIV,” said Mar­shall, adding users are more likely to ac­quire hepati­tis from shar­ing pipes.

Werker said pro­vid­ing pipes is some­thing the min­istry would con­sider depend­ing on fund­ing. She added that in­creased in­ter­est in the use of crys­tal meth pipes specif­i­cally is re­cent.

“Cer­tainly there is a recog­ni­tion that we still need to do more,” Werker said.

“We are un­der­tak­ing a ju­ris­dic­tional scan of harm re­duc­tion pro­grams, specif­i­cally around the use of pipes, and learn­ing from what other prov­inces have done.”

Mar­garet Poitras, CEO of All Na­tions Hope, a Regin­abased AIDS or­ga­ni­za­tion, said hav­ing more pipes avail­able in the prov­ince would help, but it’s not the only so­lu­tion.

“We have to bal­ance out those kinds of so­lu­tions with so­lu­tions that are get­ting to the root causes of what we’re seeing with Indige­nous peo­ple,” Poitras said.

“We need other so­lu­tions that are get­ting to the roots be­cause we don’t want to see re­volv­ing gen­er­a­tion of gen­er­a­tion not heal­ing and be­ing well.”


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